title: Oropharyngeal cancer incidence trends: diminishing racial disparities.
abstract: OBJECTIVE
  The aim of this article is to evaluate oral cavity/pharyngeal cancer (OCPC) trends that may reflect changes in cigarette smoking, alcohol consumption, and human papillomavirus (HPV) infection.
  
  
  METHODS
  We used Surveillance, Epidemiology, and End Results program data for 58,204 cases diagnosed during 1977-2007 to classify if squamous cell carcinomas of the OCP by anatomic site are potentially HPV-related.
  
  
  RESULTS
  OCPC rates among men peaked during 1982-1986 before declining, most rapidly (46%) among blacks. Rates decreased least rapidly among white males while declining at intermediate paces among other ethnic groups (Asian/Pacific Islanders and Hispanics) and females. Among the men during the recent 16-year time period, the annual percent change for HPV-unrelated sites was much steeper [-6.0% (95% CI = -7.2 to -4.9)] among blacks than whites [-2.5% (95% CI = -2.9 to -2.1)]; for HPV-related sites, it was -1.7% (95% CI = -2.6 to -0.7) among blacks, in striking contrast to +3.3% (95% CI = 2.5-4.0) among whites. HPV-related rates rose rapidly among the white men born since the mid-1940s, tripling among those aged 25-44 and recently surpassing the black male rate. Relative survival rates rose over the study period due to improvements among HPV-related cases.
  
  
  CONCLUSIONS
  The OCPC decreases found among all the race/sex groups reflect reductions in smoking prevalence and alcohol consumption. Rising HPV-related cancers among white men may reflect changes in sexual practices since the mid-1960s.
authors.affiliation: RTI International, 6110 Executive Blvd., Suite 902, Rockville, MD 20852-3907, USA. lindabrown@rti.org
authors.forename: Linda Morris
authors.initials: LM
authors.lastname: Brown
authors.forename: David P
authors.initials: DP
authors.lastname: Check
authors.forename: Susan S
authors.initials: SS
authors.lastname: Devesa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000821:virology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000821:virology; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D012307:Risk Factors; D018426:SEER Program; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult